Invited commentary: tapping the tip of the iceberg.

Recently, General Motors announced the slashing of 30,000 jobs in North America. The move will incur savings to the ailing carmaker of $7 billion a year (1). In 2004, Daimler-Chrysler agreed to a pay-freeze in exchange for job security in Germany. This year, the company announced it will lay off 8,500 workers in the very heartland of Mercedes-Benz around Stuttgart. Two days after the announcement by General Motors, the bankrupt car parts maker Delphi had to defer a $488 million executive bonus plan following a storm of criticism by unions and shareholders (2). Aren’t these times to become depressed? Thus, why wonder that Rugulies et al. (3) in this issue report on a twofold increased risk for depressive symptoms in Danish men experiencing job insecurity and in women with low influence at work or low supervisor support? However, in the case of the study by Rugulies et al., the economic conditions in Denmark at the time were quite different from the situation in most industrialized countries today: At the collection of the baseline data in 1995, few citizens doubted the Danish cradle-to-grave welfare system. Why should Danish men perceiving job insecurity be at increased risk of severe depressive symptoms 5 years later? The outcome scale measuring depression in this study was a subscale of the 36-item Short-Form Health Survey (a health-related quality-of-life instrument), asking respondents to recall the past 4 weeks (4). The job insecurity items inquired about both worries of losing a job and whether participants considered it difficult to find another job in case of unemployment. Given that depression is one of the most prevalent forms of mental illness in the industrialized world (5) and given the undulating course of depressive spells throughout life (6), could respondents with a worry-prone personality and absence of depressive symptoms in 1995 be more likely to encounter a depressive spell at follow-up in 2005? A recent report from the Whitehall II study found that more than 80 percent of the difference in depression scores in subjects with job insecurity was explained when introducing pessimism, vigilance, primary deprivation, financial security, social support, job satisfaction, and job control into the equation (7). Most data, however, support the view that individual-level factors ranging from genes (8) to personality traits or social resources amplify the effect of exposures, such as job insecurity or life events, on the risk for depression. In line with this, a recent study among middle-aged Australian managers identified the combination of job insecurity with excessive job strain as a particularly toxic synergism with odds ratios of 13.9 for depression (9). The second important finding arising from the Danish study is a gender difference in work-related psychosocial risk factors for depression. Women reporting low support by their supervisors and women perceiving low influence at work were twice as likely to experience severe depressive symptoms during the follow-up as did study participants enjoying decision latitude and supervisor support. How can these gender differences whereby job insecurity was predictive in men but social support was predictive in women be reconciled? A straightforward explanation is that there are gender differences in perceived sources of stress. It has been well described that men are more likely to be stressed by issues related to the domain of work, whereas women are more likely to be stressed by relationship concerns. The reason for this differential perception of stressors remains elusive. Is job insecurity as a psychosocial stressor linked to the social function of providing nutrition and security for the family—regardless of gender—or do such differences arise from genetic determination of male and female brains? Whatever the case, job insecurity in men and lack of social support in women appear to be perceived as chronic threats to social integrity.